There is a growing concern among those who practice the healing arts that female genital cosmetic surgery, while still a small segment of the U.S. plastic surgery market, is growing at a disconcertingly fast clip, with "thousands" of women undergoing vaginoplasties or vaginal "rejuvenations" each year. Surgeons such as Dr. John Miklos from Atlanta claim that they're providing a much-needed service that can both help enhance a woman's sexual response by surgically tightening her vagina, and boost the self esteem of women who aren't satisfied with the appearance of their vulvas. The problem with all this vaginal rejuvenation, however, is that such procedures have questionable medical validity, with some critics claiming that plastic surgeons are exploiting a pop culture ideal of what particular Venn diagram confluence of ovals and circles makes the most aesthetically pleasing vulva.

In June, Dr. Cheryl Iglesia published an editorial in the journal Obstetrics and Gynecology arguing that claims about the medical wonders of vaginoplasties were largely exaggerated or, worse, totally unfounded. "None of these procedures have proven effectiveness," wrote Iglesia, "and there is potential for harm. Women are being misled or are confused about what is normal," as well as what sort of condition or ailment can actually be ameliorated with a surgical procedure. According to critics of such vulva reconstructions, women might be spurred to undergo surgery because they have a distorted idea of what vulvas "should" look like, an impossible physical aesthetic that exists only in porn. Though vaginal rejuvenations carry risks like scarring, infection, lingering pain and the loss of the very sensations women are sometimes seeking to enhance, critics such as Iglesia warn that plastic surgeons might not thoroughly explain all the possible risks to prospective patients.

About 2,140 women underwent so-called "vaginal rejuvenation" last year, according to the American Society for Aesthetic Plastic Surgery, and the International Society of Aesthetic Plastic Surgeons pegged the U.S. total at 5,200 back in 2012. Procedures can cost anywhere from $2,500 to $12,000, and patients can span several generations, from teenagers to women in their 70s. Procedures such as "G-spot amplification" (injecting the front wall of the vagina with collagen to enhance sexual pleasure) and "revirgination" (which involves reconstructing the hymen) are also popular, though the most concerning motivations for vaginal rejuvenation procedures are revolve around aesthetics, i.e. color of the vulva, size of the labia, etc.

Porn actresses, according to critics, present women (and men) with a totally unrealistic aesthetic, and, unlike with the data that suggests plastic surgeries such as a nose-job or face-lift can, in certain instances, have social or psychological benefits, no such data exists for gential enhancements. Dr. Iglesia worries that plastic surgeons such as Dr. Miklos are preying on women's insecurities, which in turn are fostered by an imaginary "perfect" vulva that, if it could talk, let's just say, would have a voice that sounds really tinny and judgmental.